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Appendicitis

What is appendicitis?

Appendicitis is a medical emergency that happens when your appendix becomes sore, swollen, and diseased.

The appendix is a thin tube that is joined to the large intestine. It sits in the lower right part of your belly (abdomen). When you are a young child, your appendix is a working part of your immune system. The immune system helps your body to fight disease. When you are older, your appendix stops doing this. Other parts of your body keep helping to fight infection.

The appendix does not keep working when you are older, but it can get infected. If not treated it can burst (rupture). This is serious and can lead to more infection and even death.

What causes appendicitis?

Appendicitis happens when the inside of your appendix is blocked by something that makes it swell up.

If you have appendicitis, there is a serious risk your appendix may burst. This can happen as soon as 48 to 72 hours after you have symptoms. Because of this, appendicitis is a medical emergency. If you have symptoms, see a doctor right away.

Appendicitis may be caused by various infections such as virus, bacteria, or parasites, in your digestive tract. Or it may happen when the tube that joins your large intestine and appendix is blocked or trapped by stool. Sometimes tumors can cause appendicitis.

The appendix then becomes sore and swollen. The blood supply to the appendix stops as the swelling and soreness get worse. All of your body parts need the right amount of blood flow to stay healthy.

Without enough blood flow, the appendix starts to die. The appendix will burst as its walls start to get holes. These holes let stool, mucus, and other things leak through and get inside the belly. You may get peritonitis. This is a serious infection in the belly that happens when the appendix has a hole.

Who is at risk for appendicitis

Appendicitis affects 1 in 1,000 people living in the U.S. Most cases of appendicitis happen to people between the ages of 10 and 30 years. Having a family history of appendicitis may raise your risk, especially if you are a man. For a child, having cystic fibrosis also seems to raise the risk of getting appendicitis.

What are the symptoms of appendicitis?

The following are common symptoms of appendicitis. Your own symptoms may vary.

Pain in the abdomen is the most common symptom. This pain:

May start in the area around your belly button and move to the lower right-hand side of your belly. It may also start in the lower right-hand side of your belly.

Often gets worse as time goes on.

May feel worse when you are moving, taking deep breaths, being touched, and coughing or sneezing.

May be felt all over your belly if your appendix bursts.

Other common symptoms include:

Upset stomach and vomiting

Loss of appetite

Fever and chills

Trouble having a bowel movement (constipation)

Loose stool (diarrhea)

Trouble passing gas

Swollen belly

Do not take pain medicines. They may hide other symptoms your healthcare provider needs to know about.

Appendicitis symptoms may look like other health problems. Always see your healthcare provider to be sure.

How is appendicitis diagnosed?

Your healthcare provider will ask about your past health and do a physical exam. He or she may also have you take the following tests:

Blood tests. To check for signs of infection, such as having a high white blood cell count.

Urine tests. To see if you have a urinary tract infection.

You may also have some imaging tests, including:

Abdominal ultrasound. Lets you see internal organs as they work. Checks how blood is flowing through different blood vessels.

CT scan. Shows detailed images of any part of the body, such as the bones, muscles, fat, and organs.

MRI. MRI is sometimes used to diagnose appendicitis especially in a pregnant woman instead of CT scan.

How is appendicitis treated?

Appendicitis is a medical emergency. It is likely the appendix will burst and cause a serious, deadly infection. For this reason, in almost all situations, your healthcare provider will advise that you have surgery to remove your appendix.

The appendix may be removed in an open procedure or using laparoscopy:

Open (traditional) surgery method. You are given anesthesia. A cut (incision) is made in the lower right-hand side of your belly. The surgeon finds the appendix and takes it out. If the appendix has burst, a small tube (shunt) may be placed to drain out pus and other fluids in the belly. The shunt will be taken out in a few days, when your surgeon feels the infection has gone away.

Laparoscopic method. You are given anesthesia. This surgery uses several small cuts (incisions) and a camera (laparoscope) to look inside your belly. The surgical tools are placed through a few small incisions. The laparoscope is placed through another incision. A laparoscopy can often be done even if the appendix has burst.

If your appendix has not burst then your recovery from an appendectomy will only take a few days. If your appendix has burst, your recovery time will be longer and you will need antibiotic medicine.

You can live a normal life without your appendix. Changes in diet or exercise are usually not needed.

Complications of appendicitis

The main problem with appendicitis is the risk of a burst appendix. This may happen if the appendix is not removed quickly. A burst appendix can lead to infection in the belly, called peritonitis. Peritonitis can be very serious and even cause death if not treated right away.

Can appendicitis be prevented?

At this time, there is no known way to stop appendicitis from happening.

When should I call my healthcare provider?

If you have any of the symptoms of appendicitis listed above, call your healthcare provider right away. Or go to an emergency department. Appendicitis is a serious medical emergency. It should be treated as quickly as possible.

Key points about appendicitis

Appendicitis is when your appendix becomes sore, swollen, and diseased.

It is a medical emergency. You must seek care right away.

It happens when the inside of your appendix gets filled with something that causes it to swell, such as mucus, stool, or parasites.

Most cases of appendicitis happen between the ages of 10 and 30 years.

It causes pain in the belly but each person may have different symptoms.

Your health care provider will advise that you have surgery to remove your appendix.

You can live a normal life without your appendix.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

Before your visit, write down questions you want answered.

Bring someone with you to help you ask questions and remember what your provider tells you.

At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.

If you have a follow-up appointment, write down the date, time, and purpose for that visit.